Individual provider Active NPI

Michelle Darling Maurina, NP

  • Gerontology Nurse Practitioner
  • Shirley, NY
National Provider Identifier
1174172803
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
309273 Issued in NY
Practice address
800 Montauk Hwy Ste 8
Shirley, NY 11967-2128
Phone
(631) 772-4646
Fax
(631) 772-2495
NPI assigned
Sep 5, 2019
Last updated
Jan 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 309273 NY
Gerontology Nurse Practitioner 363LG0600X 309273 NY Primary

Addresses

Primary practice location

800 Montauk Hwy Ste 8
Shirley, NY 11967-2128

Mailing address

800 Montauk Hwy Ste 18
Shirley, NY 11967-2128
Phone (631) 772-4646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191023000678 NY Practitioner - Nurse Practitioner 7911239058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brookhaven Heart PLLCGroup PAC ID 6305846114, 24 clinicians

Practice addresses (Care Compare)

325 E Main St
Suite 120
Patchogue, NY 11772-3114
Phone (631) 654-3278

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brookhaven Heart PLLC CurrentSince Apr 1, 2022 Accepting new patients

Locations

325 E Main St
Ste 120
Patchogue, NY 11772
Phone (631) 654-3278

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EEFCAA
  • Direct secure messaging: michelle.maurina@bh.eclinicaldirectplus.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1174172803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MONTAUK HWY STE 18",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119672128",
            "telephone_number": "631-772-4646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MONTAUK HWY STE 8",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119672128",
            "telephone_number": "631-772-4646",
            "fax_number": "631-772-2495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURINA",
        "first_name": "MICHELLE",
        "middle_name": "DARLING",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-05",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "309273",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "309273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shirley, NY

Sources for this page

Verify at the official NPI Registry.